G9061 HCPCS Level II code: Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)
G9061 is the HCPCS code for “Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G9061Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)
Short description: Onc prac cond noadd by guide
HCPCS · United States
Medicare details
The indicators CMS publishes with G9061 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Not payable by Medicare
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Oncology - other
- Added
- Jan 1, 2006
Where G9061 sits
- 1G codesProcedures and professional services
- 2Active code G9061Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code G9061 mean?
G9061 is the HCPCS code for “Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a medicare-approved demonstration project)” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G9061?
CMS lists G9061’s Medicare coverage as “Not payable by Medicare” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside G9061
All G codesG9055Oncology; primary focus of visit; other, unspecified service not otherwise listed (for use in a medicare-approved demonstration project)G9056Oncology; practice guidelines; management adheres to guidelines (for use in a medicare-approved demonstration project)G9057Oncology; practice guidelines; management differs from guidelines as a result of patient enrollment in an institutional review board approved clinical trial (for use in a…G9058Oncology; practice guidelines; management differs from guidelines because the treating physician disagrees with guideline recommendations (for use in a medicare-approved…G9059Oncology; practice guidelines; management differs from guidelines because the patient, after being offered treatment consistent with guidelines, has opted for alternative…G9060Oncology; practice guidelines; management differs from guidelines for reason(s) associated with patient comorbid illness or performance status not factored into guidelines (for…G9062Oncology; practice guidelines; management differs from guidelines for other reason(s) not listed (for use in a medicare-approved demonstration project)G9063Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage i (prior to neo-adjuvant therapy, if any) with no evidence of…G9064Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage ii (prior to neo-adjuvant therapy, if any) with no evidence of…G9065Oncology; disease status; limited to non-small cell lung cancer; extent of disease initially established as stage iii a (prior to neo-adjuvant therapy, if any) with no evidence…G9066Oncology; disease status; limited to non-small cell lung cancer; stage iii b- iv at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved…G9067Oncology; disease status; limited to non-small cell lung cancer; extent of disease unknown, staging in progress, or not listed (for use in a medicare-approved demonstration…